Individual
DR. KELLY GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
3535 MARKET ST STE 3037, PHILADELPHIA, PA 19104-3313
(215) 746-7337
Mailing address
712 S CLIFTON ST, PHILADELPHIA, PA 19147-1978
(832) 434-1719
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
08/17/2018
Last updated
08/17/2018
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